Provider Demographics
NPI:1689762445
Name:PATEL, SADAN K (MD)
Entity type:Individual
Prefix:DR
First Name:SADAN
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8404 E. SHEA BLVD
Mailing Address - Street 2:STE 100-A
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6659
Mailing Address - Country:US
Mailing Address - Phone:480-584-5959
Mailing Address - Fax:480-584-5740
Practice Address - Street 1:8404 E. SHEA BLVD
Practice Address - Street 2:STE 100-A
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6659
Practice Address - Country:US
Practice Address - Phone:480-584-5959
Practice Address - Fax:480-584-5740
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29138207R00000X
AZAZ29138207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ579013Medicaid
AZG06971Medicare UPIN
AZZ72481Medicare ID - Type Unspecified